Meeting the Nutritional Needs of Older Patients and Family Members

When copies of the print version of this month’s issue arrived in the office, AJN staff found different meanings in the Albert Anker painting (circa. 1895) that graces the cover. Is the man enjoying a cup of tea in peace and quiet, or is he isolated and lonely, perhaps sipping tea to stave off hunger because there isn’t much food in the house?

The artist’s intent may be open to interpretation, but we chose this cover because it suggests one of the many social, cognitive, physical, and economic factors that can affect the nutritional status of older adults: eating alone.

Many older adults are at risk.

In a March CE article, “Malnutrition in Older Adults,” registered dietitian Ann Reed Mangels, PhD, RD, FADA, summarizes the latest information on malnutrition in older adults, including risk factors, assessment tools, and practical ways in which nurses as well as family and friends can help to ensure good nutrition for elders in the community or in long-term care. Writes Mangels:

“Malnutrition diminishes quality of life, is a strong predictor of short-term mortality, and is associated with higher health care costs.”

[…]

2018-03-19T09:05:08-04:00March 19th, 2018|Nursing, Patients|0 Comments

Taking Skin Tear Prevention and Management Seriously

In the Past, Approaches to Skin Tears Were Inadequate

Many years ago, when I worked in a skilled nursing facility, it seemed my patients were always experiencing skin tears. We didn’t have wound care specialists then. My approach to these injuries, which I didn’t see as serious, was to cleanse them with saline and awkwardly attempt to reposition the detached flap. In retrospect, the nursing care I provided didn’t amount to much more than “a lick and a promise.”

Greater Awareness of Risks, Dangers of Skin Tears

screen-shot-2016-11-14-at-6-09-55-pmToday, we know that skin tears can evolve into serious, complex wounds. Available data indicate that in long-term care settings, these injuries affect up to 22% of residents. Wound care specialists have developed a classification system for skin tears—as for pressure injuries, specific recommendations from wound care specialists guide our nursing care.

In this month’s AJN, author Sharon Baranoski and colleagues from the International Skin Tear Advisory Panel detail the assessment and management of skin tears in “Preventing, Assessing, and Managing Skin Tears: A Clinical Review.” While the authors emphasize the need to involve wound care nurses in the management of these injuries, many readers may find the product selection guide in this article to be especially useful.

2016-11-21T13:00:49-05:00November 14th, 2016|Nursing|3 Comments

A Measure of Contentment: One Patient’s Daily Ritual

By Annelisa Ochoa for AJN By Annelisa Ochoa for AJN

A Measure of Contentment,” the August Reflections essay in AJN, describes the daily ritual of a resident in a long-term care facility. As author Nancy Ngaruiya shows us, nurses and other health care providers can sometimes notice, and support, the small pleasures and routines that make life worthwhile for patients.

Of this patient, she writes:

We make our own happiness. We define what makes us content, what actions help us find that happiness. Sometimes the recipe takes just a few ingredients. Even in an environment where freedom is limited, where rules dictate when to wake up and go to bed, what days of the week we will get assistance with a full bath and who will do it, what meals and activities are or are not available, he has defined what makes him content, perhaps even happy.

The patient in question happens to be one of those who often get frustrated, who aren’t always grateful or helpful—those who tend to be labeled as “challenging” or “difficult” by overworked providers. It’s easy to notice only the frustration of people who’ve watched their worlds shrink bit by bit as their freedoms and abilities diminish along with their health. […]

A Room with A View: Physical Environments and Healing

By Betsy Todd, clinical editor, MPH, RN, CIC

Illustration by Janet Hamlin for AJN. All rights reserved. Illustration by Janet Hamlin for AJN. All rights reserved.

Computers, alarms, automated drug dispensing, complex medical protocols—the ways in which we provide care have changed a lot over the past 30 years. Has forced multitasking made us forget that, buried beneath the printouts and data, there is a human being in need of support?

In this month’s AJN, author Joy Washburn shares the story of David, a man with advanced Parkinson’s disease whose medical condition results in his transfer from a cheerful rehab setting to a long-term care bed in the same facility. While his old room in rehab overlooked gardens and a children’s play area, the new room faces a parking lot. To make matters worse, no one seems to have prepared David for the move, and many nurses erroneously assume that his advanced physical disability means that he is also cognitively impaired.   […]

AJN in December: Surveillance Tech, Obesity Epidemic, Questioning Catheter Size, More

AJN1214.Cover.OnlineAJN’s December issue is now available on our Web site. Here’s a selection of what not to miss.

To watch or not to watch? Long-term care facilities are challenged with providing care for a growing number of patients with dementia or intellectual disabilities. This month’s original research feature, “The Use of Surveillance Technology in Residential Facilities for People with Dementia or Intellectual Disabilities: A Study Among Nurses and Support Staff,” describes an ethnographic field study on the ethics, benefits, and drawbacks of using this technology in residential care facilities.

The obesity epidemic. Obesity rates are rising at an alarming rate in the United States. “The Obesity Epidemic, Part 1: Understanding the Origins,” the first article in a two-part series, outlines pathophysiologic, psychological, and social factors that influence weight control.

Smaller catheter size for transfusions?Changing Blood Transfusion Policy and Practice,” an article in our Question of Practice column, describes how a small team of oncology nurses designed and implemented an evidence-based project to challenge the practice that a 20-gauge-or-larger catheter is required for the safe transfusion of blood in adults. […]

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